Care for women's health, breast cancer screening
Breast cancer
Breast cancer is one of the most common malignant tumors, and its incidence is increasing year by year, and showing a younger trend. In China, there were more than 400000 new cases of breast cancer in 2020 [2]. In 2021, breast cancer overtook lung cancer to become the first malignant tumor in the world. The incidence of breast cancer remains high. A large number of evidence-based medical evidence shows that breast cancer screening can improve the early diagnosis rate of breast cancer and reduce the mortality rate. Moreover, the delay rate of breast cancer patients in our country is as high as 35%, the main reason is that they do not understand the knowledge of breast cancer prevention and neglect the examination. Therefore, it is urgent for women to understand the knowledge of breast cancer prevention and screening.
Breast Screening Classification
1. Opportunistic screening
Opportunistic screening refers to breast cancer screening conducted by health care institutions for women of the right age who come to see a doctor for various reasons, or breast cancer screening conducted by individual women on their own initiative to health care institutions.
2. Group Screening
Group screening is a breast cancer screening organized by the community or unit with the help of the equipment, technology and personnel of health care institutions for all women of the right age in the community.
Breast cancer screening methods
1. BSE Inspection
BSE refers to women's own regular breast hand examination. BSE is carried out by women themselves, which is conducive to improving women's breast health and cancer prevention awareness. It is low cost, easy to operate, and convenient for large-scale promotion and application. Early studies have shown that regular BSE can improve early diagnosis by alerting women to opportunistic screening.
2. CBE inspection
CBE refers to the examination and palpation of the breast and axilla of a woman by a clinician. Compared with BSE, the physical examination conducted by clinicians is obviously more comprehensive, detailed and accurate. Studies have shown that 5% to 10% of breast cancers can be detected by CBE alone.
3. Breast imaging examination
Breast imaging mainly includes breast ultrasound, mammography and breast MR imaging. Mammography is about 85.0 percent sensitive to screening for breast cancer in women, and 47.8 to 64.4 percent sensitive to dense glands. A large number of studies have shown that breast imaging can improve the early diagnosis rate of breast cancer and reduce the mortality rate of breast cancer.
4.Age at Breast Cancer Screening
The first peak age of female breast cancer in China is 40-45 years old, about 10 years earlier than that in western countries. Therefore, it is recommended that the age of breast cancer screening in the general risk population is 40 years old.
5. Screening of high-risk populations
1, have any of the following
First-degree relatives with a history of breast or ovarian cancer;
② Second-degree relatives with breast cancer 2 or more before the age of 50;
③ 2 or more people with ovarian cancer before the age of 50 in second-degree relatives;
④ At least one first-degree relative carries a known pathogenic genetic mutation of 1/2 gene; or carries a pathogenic genetic mutation of 1/2 gene.
2, have any of the following
① the age of menarche is not more than 12 years old;
② The age of menopause is not less than 55 years old;
③ History of breast biopsy or history of surgery for benign breast disease, or history of atypical hyperplasia of breast (lobular or ductal) confirmed by pathology;
④ The use of "estrogen and progesterone combination" hormone replacement therapy is not less than half a year;
⑤ After 45 years old, mammography showed that the type of breast parenchyma (or breast density) was inhomogeneous or dense.
3, have any two of the following
①No history of lactation or lactation time less than 4 months;
② No live birth history (including never giving birth, abortion, stillbirth) or the first live birth age is not less than 30 years old;
③ Hormone replacement therapy using only "estrogen" is not less than half a year;
④ Abortion (including spontaneous abortion and induced abortion) shall not be less than 2 times. [3]
Conclusion
WHO has clearly listed early breast cancer as a curable disease. Breast cancer screening is an effective and economical method to reduce the mortality of breast cancer and improve the early diagnosis rate and cure rate. Breast cancer screening is a long-term, regular, habitual work. A negative screening cannot completely rule out the possibility of breast cancer, and cannot completely relax their vigilance against breast disease. The majority of women should receive breast cancer screening regularly. If abnormalities are found, they should seek medical treatment in time.
References:
[1] Jia Manman, Zhi Xiuyi. Interpretation of Global Cancer Report 2020 [J]. Chinese Journal of Thoracic and Cardiovascular Surgery, 2021,28(1):8.
[2] None. Chinese expert consensus on bone health management of women with early breast cancer (2022)[J]. Chinese Journal of Cancer, 2022,32(3):13.
[3] Li Wentao. Interpretation of Chinese breast cancer screening criteria (T/CPMA014-2020) [J]. Chinese Journal of Practical Diagnosis and Therapy, 2021,35(5):3.
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